Potential screening benefit of a colorectal imaging capsule that does not require bowel preparation

Hemant Chatrath, Douglas Rex

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

INTRODUCTION: Check-Cap is a capsule device that images the colon using low-dose radiation (total dose equivalent to a plain abdominal radiograph) and does not require bowel preparation. Check-Cap is in development for colorectal cancer imaging. AIM: To survey patients in a primary care setting for their preferences for Check-Cap versus fecal occult blood testing (FOBT), including among patients who decline colonoscopy. METHODS: Patients aged 50 and older presenting to the general medicine and family practice clinics of Indiana University Health sites within a 3-month period were approached during clinic visits. A total of 502 patients who agreed to participate were given the opportunity to complete an anonymous survey (Supplementary Appendix 1, http://links.lww.com/JCG/A71) regarding their preferences for colon cancer screening. The survey presented procedure descriptions and projected accuracies for colonoscopy, FOBT, and Check-Cap. For Check-Cap, projected sensitivity was 80% for cancer and 50% for large polyps. RESULTS: The mean age of the subjects was 61.6 years, 39% were males, 44% white, 62% of patients had prior colonoscopy, and 26% had prior polypectomy. We defined 3 groups of patients-those that had never had a colonoscopy (NC)-38%, those who had a colonoscopy but no polypectomy (CNP)-36%, and those who had a colonoscopy and polypectomy (CP)-26%. Overall, 284 patients (57%) were willing to undergo a future colonoscopy. Patients with prior colonoscopy and polypectomy were more willing to get another colonoscopy than the other 2 groups (CP:CNP:NC=78%:64%: 38%; P<0.0001). Willingness to undergo colonoscopy decreased with age in all the 3 groups. Among those not willing to undergo colonoscopy, 30% were willing to undergo Check-Cap, 20% were willing for FOBT), 25% were willing to do both, and 24% were not willing for either test. Among those who declined future colonoscopy, 40% reported Check-Cap as their preferred screening test versus 22% for FOBT; P=0.0002. CONCLUSION: Our survey suggests that an imaging capsule like Check-Cap could contribute to screening adherence among patients who decline colonoscopy, provided that it can achieve projected sensitivities of 80% for cancer and 50% for large polyps.

Original languageEnglish
Pages (from-to)52-54
Number of pages3
JournalJournal of Clinical Gastroenterology
Volume48
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Colonoscopy
Capsules
Occult Blood
Polyps
Family Practice
Appendix
Patient Compliance
Ambulatory Care
Early Detection of Cancer
General Practice
Colonic Neoplasms
Colorectal Neoplasms
Neoplasms
Primary Health Care
Colon

Keywords

  • capsule
  • colonoscopy
  • fecal occult blood test
  • screening

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Potential screening benefit of a colorectal imaging capsule that does not require bowel preparation. / Chatrath, Hemant; Rex, Douglas.

In: Journal of Clinical Gastroenterology, Vol. 48, No. 1, 01.2014, p. 52-54.

Research output: Contribution to journalArticle

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abstract = "INTRODUCTION: Check-Cap is a capsule device that images the colon using low-dose radiation (total dose equivalent to a plain abdominal radiograph) and does not require bowel preparation. Check-Cap is in development for colorectal cancer imaging. AIM: To survey patients in a primary care setting for their preferences for Check-Cap versus fecal occult blood testing (FOBT), including among patients who decline colonoscopy. METHODS: Patients aged 50 and older presenting to the general medicine and family practice clinics of Indiana University Health sites within a 3-month period were approached during clinic visits. A total of 502 patients who agreed to participate were given the opportunity to complete an anonymous survey (Supplementary Appendix 1, http://links.lww.com/JCG/A71) regarding their preferences for colon cancer screening. The survey presented procedure descriptions and projected accuracies for colonoscopy, FOBT, and Check-Cap. For Check-Cap, projected sensitivity was 80{\%} for cancer and 50{\%} for large polyps. RESULTS: The mean age of the subjects was 61.6 years, 39{\%} were males, 44{\%} white, 62{\%} of patients had prior colonoscopy, and 26{\%} had prior polypectomy. We defined 3 groups of patients-those that had never had a colonoscopy (NC)-38{\%}, those who had a colonoscopy but no polypectomy (CNP)-36{\%}, and those who had a colonoscopy and polypectomy (CP)-26{\%}. Overall, 284 patients (57{\%}) were willing to undergo a future colonoscopy. Patients with prior colonoscopy and polypectomy were more willing to get another colonoscopy than the other 2 groups (CP:CNP:NC=78{\%}:64{\%}: 38{\%}; P<0.0001). Willingness to undergo colonoscopy decreased with age in all the 3 groups. Among those not willing to undergo colonoscopy, 30{\%} were willing to undergo Check-Cap, 20{\%} were willing for FOBT), 25{\%} were willing to do both, and 24{\%} were not willing for either test. Among those who declined future colonoscopy, 40{\%} reported Check-Cap as their preferred screening test versus 22{\%} for FOBT; P=0.0002. CONCLUSION: Our survey suggests that an imaging capsule like Check-Cap could contribute to screening adherence among patients who decline colonoscopy, provided that it can achieve projected sensitivities of 80{\%} for cancer and 50{\%} for large polyps.",
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